The marriage between a political movement that prioritized limited government and social and cultural conservatives has always had its ups and downs. But post-Roe America has put on display some of the tensions on the political right. In particular, an ongoing battle in Mississippi sheds a harsh light on the divide between a politics that focuses on ending abortion and one that prioritizes shrinking the size of government.

States have responded to the new landscape in different ways. Texas led the way with a $100 million down payment on a post-Roe future, supercharging its Alternatives to Abortion program that funds crisis pregnancy centers that serve mothers in need. Indiana also increased its support for pregnant moms, but not before some Republicans wanted to strip that funding and turn it into tax cuts

You couldn’t make up a parody of outdated economic orthodoxy hamstringing an authentically conservative approach to governing, and Indiana Gov. Eric Holcomb is to be commended for ensuring that the $45 million earmarked for the Hoosiers First Family Fund will go to maternal health, child care and supporting low-income families. 

Other states are dropping the ball as the conservative movement’s anti-abortion and limited government sensibilities collide. Look no further than the state that brought the Dobbs case before the Supreme Court: Mississippi. 

Mississippi and other red states will always have less fiscal room to spend on safety net programs than big blue states like California or New York. But Republican-led states will need to be creative about supporting women to make clear that the charges of being anti-abortion only until birth are false, especially in the face of viral misinformation about threats to women’s health. 

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In response to Dobbs, the state legislature did provide $3.5 million in tax credits for crisis pregnancy centers, a modest first step that is the equivalent of about $580 per women who chose abortion in Alabama in 2019. 

Despite what viral social media posts might claim, most abortions are undertaken for elective reasons, often economic in nature — mothers feel overwhelmed by the thought of having another mouth to feed, or are concerned about professional ramifications. Simply banning abortions from being performed in the state won’t set those mothers’ minds any more at ease, and changing the economic calculus facing them will require more than the equivalent of $580 in tax credits. 

One easy way would be for the state to sign onto a federal provision that would extend postpartum Medicaid coverage for new moms for a year after birth. Under current law, states are only required to provide postnatal coverage for 60 days postpartum, leaving new moms at risk of pregnancy related complications and higher rates of maternal mortality. 

Congress passed a law that would extend that coverage for a year post-birth, splitting the costs between the states and the federal government. Twenty-nine states have already done so, including deeply Republican states like South Carolina, Indiana, Tennessee and Louisiana, while eight more are planning to do so in part or in full.

But some of Mississippi’s elected officials have refused to take that step. Last year, Republicans in the state Senate voted 46-5 to extend Medicaid for a year postpartum (and many still support the provision), only to have the effort quashed by Speaker of the House Philip Gunn, who told reporters, “I believe we should be working to get people off Medicaid as opposed to adding more people to it.” 

It’s unclear whether the speaker was misinformed or deliberately obfuscating, and my emailed request for clarification went unanswered. The provision in question would not expand eligibility for pre- and postnatal care in Medicaid (though, as I have written elsewhere, fully anti-abortion states should consider doing so). The only question before the legislature was whether the state of Mississippi — which finances 60% of births in the state — should extend its coverage longer after birth, partially subsidized by the federal government. 

Gunn isn’t alone. Andy Gipson, the state’s commissioner of the Department of Agriculture and Commerce, told county fairgoers that he supported utilizing private insurance instead of extending postpartum coverage, saying “able-bodied folks ought to get off the couch and go to work.” But the population in question is Medicaid-eligible moms in Mississippi; for context, that means a mom making less than $37,000 a year, who gave birth less than two months ago. 

The response from staunchly anti-safety-net Republicans is that these women should lose their health care coverage 61 days after the birth of their baby. That mentality should be unacceptable, especially in a post-Roe world. 

A lack of postpartum medical coverage is probably not what pushes low-income moms to consider abortion. But it does contribute to higher risks of complications and makes giving birth riskier for low-income moms. In a post-Roe landscape, it is essential that abortion opponents stand up in favor of the health and wellbeing of mothers and the babies they carry — for political reasons, in addition to moral ones. Extending the length of time that low-income moms can receive medical coverage is low-hanging fruit, and the bare minimum of what social conservatives should be pushing for in building a culture of life. 

Anti-abortion conservatives in Mississippi and other red states should be banging on the door of their elected officials, ensuring that extending the length of Medicaid coverage is brought up again in the upcoming legislative session. To do so, anti-abortion movement will have to agree to disagree with its usual political bedfellows on the small-government right. 

In the first, heady weeks after the Court’s decision in Dobbs — a decision which so many who had worked and prayed for an end to abortion had long sought — a certain amount of reorientation was to be expected. A movement that had struggled for half a century just to gain the ability to regain the ability to pass state laws protecting the unborn could be excused for taking a moment to ask itself “What next?”

But the movement’s hard-fought victory is being put at risk. The results in abortion-related ballot initiatives last fall suggest voters are suspicious of the anti-abortion side’s willingness to address not just the legal supply of abortion, but the factors that lead many women to considering it in the first place. An authentically anti-abortion agenda should include robust support for maternal health and other resources to help moms carry their baby to term. 

Patrick T. Brown (@PTBwrites) is a fellow at the Ethics and Public Policy Center, where he works on EPPC’s Life and Family Initiative.